Many feel like 'guests in their own home,' study finds
FRIDAY, Aug. 17 (HealthDay News) -- Depression may be a largely unrecognized problem for many U.S. soldiers returning from duty in Iraq or Afghanistan, placing a tremendous strain on them and their families, a new study suggests.
Researchers studied the home life of 168 soldiers diagnosed with psychological symptoms upon their return home from deployment. Nearly half -- 42 percent -- of these veterans said they now felt like a "guest in their own home," and one in five felt their children did not respond warmly to them, or were even afraid of them.
In many of these cases, depression or another psychological problem, post-traumatic stress disorder (PTSD), played a major role, the researchers said.
The PTSD finding has been observed in other studies, but the link between returning veterans' depression and family trouble is new, experts said.
"It seems like other kinds of mental health issues, besides PTSD, are also resulting in family problems," said lead researcher Steven Sayers, an assistant professor of psychology in psychiatry and medicine at the University of Pennsylvania.
"It all sort of spirals, because if you are not feeling supported by your family members and feeling warmth from your spouse and children, you have greater difficulty recovering from symptoms of depression or PTSD," said Sayers, who is also a clinical psychologist at the Mental Illness Research, Education & Clinical Center, part of the Philadelphia VA Medical Center.
One expert applauded the study, which is to be presented Friday at the American Psychological Association annual meeting in San Francisco.
"It underscores the fact that deployments are tough on all family members -- they're tough on the parent who cares for the children and holds the household together while the soldier is gone, and for the entire family that has to deal with all the soldier's experiences once they return," said Deborah Gibbs, a senior analyst for the Children and Families Program at RTI International, in Research Triangle Park, N.C.
Gibbs led a study, published in July in the Journal of the American Medical Association, that found the children of soldiers who saw combat in Iraq were at heightened risk of abuse or neglect when their parent returned home.
In the new study, Sayers' team examined the home life of U.S. soldiers returning from service in either Iraq or Afghanistan. The soldiers had not suffered any grievous physical injury, but routine psychiatric evaluations, conducted upon their return, turned up signs of depression, PTSD or other mental woes.
About 40 percent of the veterans were either married or cohabiting with a partner, 21 percent were recently separated or divorced, and about half had at least one child.
Sayers stressed that the groups studied "are not representative of returning vets as a whole," but are a subset diagnosed with mental health symptoms after deployment. Those types of troubles aren't rare, however: One 2006 study found that one-third of U.S. soldiers returning from Iraq and Afghanistan are availing themselves of mental health services. And a government report released Thursday found there were 99 confirmed suicides among U.S. Army soldiers in 2006, the highest rate in 26 years. More than 25 percent of those who committed suicide did so while serving in Iraq and Afghanistan.
In the new study, a diagnosis of either major or minor depression, or PTSD, was highly correlated with family problems, the researchers found.
Those troubles included physical or mental abuse. For example, 56 percent of soldiers with current or recently separated partners reported severe conflicts with partners resulting in "shouting, pushing or shoving," and 35 percent felt their partner was now fearful of them.
Two-thirds of married or co-habitating veterans said that several episodes of "family conflict" or "readjustment" occurred each week, and nearly 36 percent said they were now "unsure about their role" in the home.
That's a common scenario, Gibbs said.
"Research from the '90s that came about as a result of the Desert Storm deployments gave us a lot of evidence of issues like this, evidence of behavioral problems by children, anxiety on the part of spouses and of how difficult it is for everyone to adjust to new roles, or a change in roles, once a soldier returns," she explained.
Often, children have changed over a deployment and a returning parent may not understand this, Gibbs said. "Time doesn't stand still for families. Especially adolescents, who change so quickly in the space of a year -- you can expect it to be very tough [sometimes] for parents and adolescents to get back in tune with each other," she said.
A veterans' family may not understand how the war has changed him or her, either. "They may anticipate that the veteran will be happy, like the old person that went off to war," Sayers said.
He stressed that because the men and women in the study had not had a psychiatric assessment prior to their deployment, it is impossible to tell if the depression was caused by the war.
"I'm certainly not saying in the study that what they are feeling is directly attributable to their war experiences," Sayers said. "However, we do know that increased exposure to wartime trauma does increase risk for all kinds of mental-health issues."
The important thing, the experts said, is to recognize problems early and get veterans the help they need.
That's not always easy, though, because "one of the hallmarks of depression is that people may not recognize that it's a problem that they can get help with," Gibbs pointed out.
That's where the support of family and friends comes in, the experts said.
"The issue here is to gently encourage the veteran to seek treatment, to offer to be involved," Sayers said. "These offers may need to be repeated. It's often not useful to insist or push the veteran to get treatment, but to just make it easy for them to seek treatment if they sense that it is what [they] need."
He said the Veterans Administration does have good outreach and treatment programs in place, to help soldiers and their family members who might suffer from these types of problems.
In the meantime, Gibbs said, American families, for the most part, are winning "the war at home."
"Military families do a tremendous job in getting through these very tough experiences -- most of them do a wonderful job," she said. "These experiences are understandably quite tough, and this kind of study shows the importance of family members getting help when they need it."
For more on mental health services available to veterans, visit the U.S. Department of Health and Human Services.
SOURCES: Steven Sayers, Ph.D., assistant professor, psychology in psychiatry and medicine, University of Pennsylvania, and clinical psychologist, Mental Illness Research, Education & Clinical Center, Philadelphia VA Medical Center; Deborah Gibbs, M.S.P.H., senior analyst, Children and Families Program, RTI International, Research Triangle Park, N.C., Aug. 17, 2007, presentation, American Psychological Association annual meeting, San Francisco